Usefulness of Intraoperative Parathyroid Hormone Assay in Minimally Invasive Surgery

Background and Objectives:Intraoperative parathyroid hormone (PTH) assay has been proposed as an effective tool in minimally invasive parathyroidectomy. We evaluated its usefulness during minimally invasive parathyroidectomy. Subjects and Method:Ten patients (female 6, male 4) of primary hyperparathyroidism (8 single diseases, 2 multiple diseases) were analyzed retrospectively. We used computed tomography (CT) and 99m Tc-Sestamibi (MIBI) scan for localization of parathyroid lesions preoperatively, and frozen biopsy and PTH assay at 10 (T-10), 20 (T-20) minutes after excision intraoperatively. We also compared the diagnostic sensitivity of CT and MIBI scan and intraoperative PTH. Results:All patients were treated successfully and in single disease group, diagnostic sensitivity of CT, MIBI scan were 75% and 87.5%, and that of T-10 was 75% and T-20 was 100%. In multiple disease group, diagnostic sensitivity of CT, MIBI scan were 75%, 87.5%, and that of PTH was 80%. Conclusion:Intraoperative PTH assay improves cure rate in minimally invasive parathyroidectomy. It allowed intraoperative recognition of missed parathyroid lesions by preoperative imaging study. (Korean J Otorhinolaryngol-Head Neck Surg 2009;52:426-30)

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